Alcoholic ketoacidosis

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Alcoholic Ketoacidosis
Classification and external resources
SpecialtyInternal medicine
eMedicinemed/102

Alcoholic ketoacidosis is a common reason for admission of alcohol dependent persons in hospitals emergency rooms. The term refers to a metabolic acidosis syndrome caused by increased ketone levels in serum. Glucose concentration is usually normal or a little lower.

In 1940, Drs Edward S. Dillon, W. Wallace, and Leon S. Smelo, first described alcoholic ketoacidosis as a distinct syndrome. They stated that "because of the many and complex factors, both physiologic and pathologic, which influence the acid-base balance of the body, a multitude of processes may bring about the state of acidosis as an end result."[1]

In 1971, David W. Jenkins and colleagues described cases of three non‐diabetic patients with a history of chronic heavy alcohol misuse and recurrent episodes of ketoacidosis. This group also proposed a possible underlying mechanism for this metabolic disturbance, naming it alcoholic ketoacidosis.[2]

Patients regularly report nausea, vomiting, and pain in abdomen which are the most commonly observed complaints. This syndrome is rapidly reversible and, if taken care of has a low mortality. Other patients present tachypnoea, tachycardia, and hypotension.[3]

The main differences between patients with diabetic ketoacidosis is that patients with alcoholic ketoacidosis are usually alert and lucid despite the severity of the acidosis and marked ketonaemia.[4]

However, there are cases where alcoholic ketoacidosis can cause death of the patient if not treated with administration of dextrose and saline solutions.[5]

References[edit]

  1. ^ Dillon, E.; Dyer, W. Wallace; Smelo, L. S. (November 1940). "Ketone Acidosis in Nondiabetic Adults". Medical Clinics of North America. 24 (6): 1813–1822. doi:10.1016/S0025-7125(16)36653-6.
  2. ^ Jenkins, David W.; Eckel, Robert E.; Craig, James W. (12 July 1971). "Alcoholic Ketoacidosis". JAMA: The Journal of the American Medical Association. 217 (2): 177. doi:10.1001/jama.1971.03190020037007.
  3. ^ Wrenn, KD; Slovis, CM; Minion, GE; Rutkowski, R (August 1991). "The syndrome of alcoholic ketoacidosis". The American Journal of Medicine. 91 (2): 119–28. PMID 1867237.
  4. ^ McGuire, L C (1 June 2006). "Alcoholic ketoacidosis". Emergency Medicine Journal. 23 (6): 417–420. doi:10.1136/emj.2004.017590. PMC 2564331.
  5. ^ Brutsaert, Erika F. "Alcoholic Ketoacidosis". Merck Manual. Merck Sharp & Dohme Corp. Retrieved 2 February 2018.